Individual provider Active NPI

Laquita Streeter, COTA/L

  • Occupational Therapy Assistant
  • Bedford, TX
National Provider Identifier
1942895362
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216448 Issued in TX
Practice address
404 Racquet Club Blvd
Bedford, TX 76022-6408
Phone
(682) 738-3056
NPI assigned
Mar 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-2943 MS
Occupational Therapy Assistant 224Z00000X 216448 TX Primary

Addresses

Primary practice location

404 Racquet Club Blvd
Bedford, TX 76022-6408

Mailing address

302 Starlight Dr
Yazoo City, MS 39194-8549
Phone (662) 763-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA-2943MSMDOccupational Therapy Assistant
216448TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hands Big Hearts Pediatric Therapy Management Inc PastSince Mar 16, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1942895362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 STARLIGHT DR",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391948549",
            "telephone_number": "662-763-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 RACQUET CLUB BLVD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226408",
            "telephone_number": "682-738-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETER",
        "first_name": "LAQUITA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "OTA-2943",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.